PDD Concern Resolution Processes

Intent

To describe the options available to Individuals and their guardians for addressing PDD related concerns in a consistent, fair and timely manner.

Policy

All PDD decisions affecting an Individual’s receipt of services or eligibility to receive services will be communicated by PDD to the Individual and/or their guardian in writing in the Notice of Decision letter.

The Notice of Decision letter will contain:

  • The decision
  • The reason(s) for the decision
  • The date of the decision
  • Information on concerns resolution options available to the Individual if they disagree with the decision including a review of the decision, mediation and appeal, as well as the related forms and timelines.

If an Individual and/or their guardian are not satisfied with a decision that affects their services or has a concern regarding the PDD program, the PDD program will work with the Individual and/or their guardian to provide options to address their concerns in a consistent, fair and timely manner.

Individuals who have a concern regarding the PDD program have the right to express their concern and to expect an effective system to hear and resolve their concern.

  • Concerns are taken seriously and will influence the review and continuous improvement of service delivery practices.
  • Concern resolution policies and procedures are an integral part of overall quality assurance.
  • The Individual, guardian or others assisting them to resolve their concern will not be subject to reprisals as a result of voicing a concern.

The Concern Resolution Process is transparent and ensures the Individual and/or their guardian are clearly informed of the decision and how it was made. There is a continuum of options available for concerns resolution, which includes:

  • Administrative Review; and/or,
  • Mediation; and/or,
  • Appeal.

Administrative Review

An administrative review is available as first steps to resolve concerns. The administrative review offers opportunities to identify creative solutions at the local community and/or zone-region level, maintain and/or strengthen relationships and save time, energy and resources for both parties.

At any time up to 30 calendar days, after receiving Notice of Decision, an Individual and/or their co-decision maker or guardian can request the review of a PDD decision by contacting their delivery staff or their supervisor.

Generally, the administrative review involves a meeting between the Individual and/or their supporter, co-decision maker or guardian and a senior delivery staff whose area of responsibility is different from that of the delivery staff who made the initial decision.

Steps in the Administrative Review process:

  1. The Individual and/or their guardian can request an administrative review of a PDD Decision any time up to 30 calendar days after receiving Notice of Decision.
  2. The administrative review of a PDD Decision occurs prior to mediation.
  3. An Individual and/or their co-decision maker/guardian may make a request for review of a PDD decision by contacting their delivery staff.
  4. The decision will be reviewed by a senior delivery staff that did not make the initial decision.
  5. The administrative review should be completed within 15 working days from the date the request was made.

Following the administrative review, an Individual and/or co-decision maker/guardian may agree with the outcome of the review or choose whether to participate in mediation, an appeal or both if their concern has not been resolved. While the goals of mediation and appeal are the same, the processes and persons involved in these processes vary.

Mediation

Mediation is a legislated, voluntary process that provides the opportunity to resolve the Individual’s concern in a collaborative way through the use of a neutral, independent, qualified third party mediator.

In mediation, a professional mediator is used to help resolve the concern. The mediator facilitates a process that is intended to support the parties to reach a mutually satisfactory resolution through open communication and creative problem solving. The mediator educates participants, answers questions regarding the process and makes suggestions. The suggestions of the mediator may or may not lead to decisions by both parties to resolve the concern.

All information provided by the Individual and/or their supporter/co-decision maker/guardian during the mediation process is kept confidential.

If the Individual and/or their co-decision maker/guardian choose to go to mediation (instead of directly to appeal), a Request for Mediation form must be submitted to the relevant disability services office within 30 calendar days from the day the Individual was notified in writing of the decision.

The time limits for submission of a Request for Mediation and/or Notice of Appeal are not suspended during the administrative review of a PDD Decision; however, may be withdrawn if the concern is resolved through the review.

The Individual and/or their guardian and the relevant delivery staff will participate in mediation. All participants are encouraged to provide their ideas about potential solutions, collaborate, and make all reasonable efforts to arrive at a mutually agreeable resolution.

If the mediation process results in a mutually agreed upon decision, the details of this decision are reflected in a written mediation agreement. Copies of the mediation agreement are provided to participants at the end of the mediation. The mediation agreement reflects assigned activities and timelines by which agreed to activities will occur.

In the event an agreement cannot be reached within 30 days, the mediator may:

  • Recommend terms for settlement to the parties for them to accept or reject within a time fixed by the mediator; or,
  • Notify the parties within three calendar days that no recommendation will be made and that the Individual may, within 30 calendar days of receiving the mediator’s notice, appeal the decision of the Director.

Steps involved in Mediation Process
Delivery staff will discuss mediation as one of the resolution options available to the individual.

  1. If the individual and/or their co-decision maker/guardian requests mediation, delivery staff will provide them with a Request for Mediation form and explain that the request be completed and returned to the local disability services office within 30 days of receiving the Notice of Decision.
  2. Upon receipt of the completed Request for Mediation form, the Disability Services Director or designate will appoint a mediator within a reasonable time frame. The mediator will be identified by Dispute Resolution Services.
  3. The Disability Services Director or designate will identify the delivery staff who will represent PDD during the mediation process.
     
    • The identified delivery staff will have the authority to represent the program and make decisions within the parameters of the authority granted to them about the individual’s services during the mediation process.
    • Whenever possible, and in keeping with the principles and intent of mediation, the delivery staff chosen to participate will have an established relationship with the individual and an understanding of the case being mediated.
    • Delivery staff will participate in the process with the goal of identifying creative solutions that fall within the scope of PDD program policy and arriving at a mutually agreed upon decision.
  4. There will be no bias or action taken against an Individual or guardian who requests and participates in mediation.
  5. The delivery staff will provide the Individual with the name and contact information of the mediator after receiving this information from the Director. The delivery staff will also advise the Individual and/or their guardian of their right to have an advocate or other support person present at the mediation, and will provide information for advocacy supports when needed.
  6. When agreement is achieved, the parties will enter into a mediation agreement, copies of which will be provided to participants at the end of the mediation. Disability Services will promptly take action as required based on the mediation agreement.

While the PDD Regulation s.3 (4) permits cost sharing of the mediator’s fees and expenses, when it is not feasible for the individual to participate in cost-sharing with PDD due to financial inability, the disability services zone will cover the costs.

Appeal

Appeal is the highest step in the process of PDD Concern Resolution. It involves a panel (the Appeal Panel) appointed for the purpose of hearing the concern and finding ways to resolve it. The decisions of the Appeal Panel are final in the process of concern resolution in PDD.

An appeal is a legislated, formal request to have a group of people review a decision made by the PDD program. The PDD Appeal Panel is made up of private citizens who are appointed by the Minister and have the authority to hear and make decisions on appeals. The Appeal Panel can confirm, reverse, or vary the decision.

Only an Individual (or their guardian) who is receiving services or has applied to receive services, and is affected by a PDD (or director’s) decision regarding those services can appeal a decision. Agencies and other third parties cannot appeal PDD decisions. A decision can be appealed:

  • Within 45 days of being informed of a decision that they do not agree with and have decided not to request mediation; or,
  • Up to 30 days following the conclusion of the mediation process, if they are still not satisfied with the outcome.

It should be noted that while most decisions made by the PDD program can be appealed if they affect services, there are a few exceptions. Decisions that cannot be appealed include:

  • Decisions to enter into a contract with a service provider;
  • Decisions to end a contract with a service provider; and,
  • Decisions to change a contract with a service provider.

Steps in the Appeal Process

  1. To proceed with an appeal, the individual must submit a Notice of Appeal form to the Appeal Secretariat. The Appeal Secretariat will determine if the Notice of Appeal is accepted. This includes whether it is within the timelines, and if not; if there is reasonable grounds to grant an extension; and whether it is something that can be appealed.
  2. Only an Individual or their guardian who is receiving services or has applied to receive services and is affected by a PDD (or director’s) decision regarding those services can appeal a decision.
  3. Individuals can file their appeal themselves or with assistance. An Individual’s guardian under the Adult Guardian and Trusteeship Act or their agent as defined under the Personal Directives Act can file an appeal on behalf of the individual.
  4. If the Individual chooses to go through mediation but an agreement could not be reached, the option of appeal becomes available once the mediation process has been concluded. A 30-calendar day time limit for submission of a Notice of Appeal starts the day after the conclusion or abandonment of mediation.
  5. If the Individual did not choose mediation, they must submit the appeal form within forty-five (45) calendar days of receiving written notification of the original decision date.

Flowchart of the PDD Concern Resolution Process

Information about the PDD program appeal process and related forms are available from the Appeal Secretariat. The Appeals Secretariat can be reached by calling 780-427-2709 or by email at css.appealssec-pdd-fscd@gov.ab.ca.

Legislative Authority

Created: 2013-08-16
Modified: 2022-01-21
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